April 17, 2012Catheterization and Cardiovascular Interventions
Predictors of an optimal clinical outcome with alcohol septal ablation for obstructive hypertrophic cardiomyopathy
Key result
Alcohol septal ablation yielded superior 4-year survival free of death and severe symptoms in patients with ≥3 optimal baseline characteristics (90.4%) compared to those with ≤1 characteristic (57.5%).
Why the study?
What are the clinical and anatomic predictors of survival free of death and severe symptoms following alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy?
Population
166 patients with obstructive hypertrophic cardiomyopathy who underwent alcohol septal ablation at Mayo…
Design
Cohort
Follow-up
4 years
Authors
Discussion
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Implication
Patient factors predict optimal alcohol septal ablation outcomes in obstructive HCM; leaves open need for prospective validation before changing selection.
Key Points
- This study aimed to identify predictors of success for alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy.
- Evaluated 166 HCM patients who underwent alcohol septal ablation at Mayo Clinic.
- Analyzed patient characteristics, cardiac morphology, and procedural data.
- Primary endpoint assessed was survival free from death and severe symptoms.
- Patients with ≥3 predictive characteristics had 90.4% survival free of severe symptoms at 4 years.
- Only older age, lower left ventricular outflow tract gradient, lesser septal hypertrophy, and smaller LAD diameter predicted clinical success.
- Greater case volume with >50 patients independently predicted survival free of severe symptoms.
Study Design
Type
Cohort (n=166)
Multicenter
No
Structured PICO
What are the clinical and anatomic predictors of survival free of death and severe symptoms following alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy?
P
Population
166 patients with obstructive hypertrophic cardiomyopathy (mean age 63 years, 57% female) who underwent alcohol septal ablation, evaluated for predictors of 4-year survival free of severe symptoms.
E
Exposure
Alcohol septal ablation
O
Outcome
Survival free of death and severe symptoms (New York Heart Association, class III or IV dyspnea)composite
Main Result
Absolute Event Rate: 90.4% vs 57.5%
Optimal outcomes after alcohol septal ablation for obstructive hypertrophic cardiomyopathy are strongly predicted by older age, less severe left ventricular outflow tract gradient, lesser septal hypertrophy, smaller LAD diameter, and higher operator case volume.
Cite This Study
Sorajja et al. (2012) conducted a cohort in obstructive hypertrophic cardiomyopathy (n=166). Alcohol septal ablation vs. Patients with ≤1 optimal baseline characteristic was evaluated on survival free of death and severe symptoms (New York Heart Association, class III or IV dyspnea). Alcohol septal ablation yielded superior 4-year survival free of death and severe symptoms in patients with ≥3 optimal baseline characteristics (90.4%) compared to those with ≤1 characteristic (57.5%).